[Simulation of difficult airway management for residents: prospective comparative study]

Area of Science:

• Medical Education
• Anesthesiology
• Emergency Medicine

Background:

• Difficult airway management is a critical skill for anesthesiology and intensive care residents.
• Procedural simulation offers a potential avenue for enhancing training in this area.
• The study investigates the long-term impact of a specific simulation protocol on resident performance.

Purpose of the Study:

• To evaluate if 3 hours of procedural simulation training for difficult airway management improves device acquisition, resident behavior, and patient outcomes at 6 months.
• To compare the outcomes of residents who underwent simulation training with a control group.
• To assess the cost-effectiveness of the simulation intervention.

Main Methods:

• Prospective comparative study involving second-year anesthesiology and intensive care residents at two medical universities.
• Intervention group received 3 hours of procedural simulation training; control group received no intervention.
• Self-assessment forms on device experience were administered before and 6 months after the intervention. Primary endpoint: frequency of difficult airway device use at 6 months. Secondary endpoints: changes in knowledge, skills, and patient outcomes.

Main Results:

• 44 residents in the intervention group and 16 in the control group were included.
• No significant difference in the primary endpoint (frequency of device use) was observed between groups at 6 months.
• The intervention group showed improved knowledge and skills for all devices, and improved patient outcomes with the malleable intubation stylet and Eschmann introducer. No improvements were noted in the control group. Intervention cost: 406€ per resident.

Conclusions:

• A 3-hour procedural simulation for difficult airway management did not enhance the frequency of device use by residents at 6 months.
• Despite not improving device usage frequency, the training positively impacted residents' knowledge, skills, and patient outcomes for specific devices.
• Further research is warranted to determine the optimal balance between training duration and acquisition efficiency in difficult airway management simulation.